Public Health and Hospitals is State Subject, hence all the matters related to health system strengthening, including rural areas, lie with the respective State/UT Governments. However, under National Health Mission, the Ministry of Health & Family Welfare provides financial and technical support to States/UTs to strengthen their healthcare systems including support for the recruitment of doctors based on the requirements posed by them in their Programme Implementation Plans (PIPs) within their overall resource envelope.
Under NHM, the following types of incentives and honorarium are provided for encouraging doctors to practice in rural and remote areas of the country:
- Hard area allowance to specialist doctors for serving in rural and remote areas and for their residential quarters so that they find it attractive to serve in public health facilities in such areas.
- Honorarium to Gynecologists/ Emergency Obstetric Care (EmoC) trained, Pediatricians & Anesthetist/Life-Saving Anesthesia Skills (LSAS) trained doctors is also provided to increase the availability of specialists for conducting Cesarean Sections in rural & remote areas.
- Incentives like special incentives for doctors, incentives for ANM for ensuring timely ANC checkups and recording, and incentives for conducting Adolescent Reproductive and Sexual Health activities.
- States are also allowed to offer a negotiable salary to attract specialists including flexibility in strategies such as “You Quote We Pay”.
- Non-Monetary incentives such as preferential admission in post-graduate courses for staff serving in difficult areas and improving accommodation arrangements in rural areas have also been introduced under NHM.
- Multi-skilling of doctors is supported under NHM to overcome the shortage of specialists. Skill-up-gradation of existing HR is another major strategy under NRHM for achieving improvement in health outcomes.
- As per Section (51) of the NMC Act, 2019, the regulations of the National Medical Commission of India provide for the incentive of marks at the rate of up to 10% for each year of service in rural/ remote/ difficult areas of the State and maximum up to 30% in NEET (PG) for admission to PG medical courses. Further, 50% of medical diploma seats are reserved for the in-service medical doctors of the State Government who have served in remote and/ or difficult areas.